African Journal of
Biotechnology

  • Abbreviation: Afr. J. Biotechnol.
  • Language: English
  • ISSN: 1684-5315
  • DOI: 10.5897/AJB
  • Start Year: 2002
  • Published Articles: 12485

Full Length Research Paper

Dynamics of the vaginal microbiome during the menstrual cycle of HIV positive and negative women in a sub-urban population of Kenya

Teresa N. Kiama
  • Teresa N. Kiama
  • Department of Medical Physiology, University of Nairobi, Kenya.
  • Google Scholar
Mario Vaneechoutte
  • Mario Vaneechoutte
  • Laboratory for Bacteriology Research, Faculty of Medicine and Health Sciences, University of Ghent, Belgium.
  • Google Scholar
Paul M. Mbugua
  • Paul M. Mbugua
  • Department of Medical Physiology, University of Nairobi, Kenya.
  • Google Scholar
Hans Verstraelen
  • Hans Verstraelen
  • Department of Obstetrics & Gynaecology, Ghent University hospital, Belgium.
  • Google Scholar
Benson Estambale
  • Benson Estambale
  • University of Nairobi Institute of Tropical and Infectious Diseases (UNITID), Kenya.
  • Google Scholar
Marleen Temmerman
  • Marleen Temmerman
  • Department of Obstetrics & Gynaecology, Ghent University hospital, Belgium.
  • Google Scholar
Rita Verhelst
  • Rita Verhelst
  • Laboratory for Bacteriology Research, Faculty of Medicine and Health Sciences, University of Ghent, Belgium.
  • Google Scholar


  •  Received: 12 January 2023
  •  Accepted: 28 August 2023
  •  Published: 30 November 2023

References

Allsworth JE, Peipert JF (2007). Prevalence of bacterial vaginosis: 2001-2004 National Health and Nutrition Examination Survey data. Obstetrics & Gynecology 109(1):114-120.
Crossref

 

Allsworth JE, Lewis VA, Peipert JF (2008). Viral sexually transmitted infections and bacterial vaginosis: 2001-2004 National Health and Nutrition Examination Survey data. Sexually Transmitted Disease 35:791-796.
Crossref

 

Antonio MA, Hawes SE, Hillier SL (1999). The identification of vaginal Lactobacillus species and the demographic and microbiologic characteristics of women colonized by these species. Journal of Infectious Diseases 180(6):1950-1956.
Crossref

 

Anukam KC, Osazuwa EO, Ahonkhai I, Reid G (2006). Lactobacillus vaginal microbiota of women attending a reproductive health care service in Benin city, Nigeria. Sexually Transmitted Diseases 33(1):59-62.
Crossref

 

Apalata T, Nojaholo S, Seipone ID, Nxasana N (2021). Characterizations of Bacterial Vaginosis among HIV-Positive and HIV-Negative Women in Rural Eastern Cape Province, South Africa. International Journal of Microbiology 2021:1-6.
Crossref

 

Baeten JM, Hassan WM, Chohan V, Richardson BA, Mandaliya K, Ndinya-Achola JO, Jaoko W, McClelland RS (2009). Prospective study of correlates of vaginal Lactobacillus colonisation among high-risk HIV-1 seronegative women. Sexually Transmitted Infections 85(5):348-353.
Crossref

 

Bartlett JG, Onderdonk AB, Drude E, Goldstein C, Anderka M, Alpert S, McCormack WM (1977). Quantitative bacteriology of the vaginal flora. Journal of infectious Diseases 136(2):271-277.
Crossref

 

Bayigga L, Kateete DP, Anderson DJ, Sekikubo M, Nakanjako D (2019). Diversity of vaginal microbiota in sub-Saharan Africa and its effects on HIV transmission and prevention. American Journal of Obstetrics and Gynecology 220(2):155-166.
Crossref

 

Beigi RH, Wiesenfeld HC, Hillier SL, Straw T, Krohn MA (2005). Factors associated with absence of H2O2-producing Lactobacillus among women with bacterial vaginosis. Journal of Infectious Diseases 191(6):924-929.
Crossref

 

Boskey ER, Telsch KM, Whaley KJ, Moench TR, Cone RA (1999). Acid production by vaginal flora in vitro is consistent with the rate and extent of vaginal acidification. Infection and Immunity 67(10):5170-5175.
Crossref

 

Bradshaw CS, Morton AN, Hocking J, Garland SM, Morris MB, Moss LM, Horvath LB, Kuzevska I, Fairley CK (2006). High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. Journal of Infectious Diseases 193(11):1478-1486.
Crossref

 

Brotman RM, Ghanem KG, Klebanoff MA, Taha TE, Scharfstein DO, Zenilman JM (2008). The effect of vaginal douching cessation on bacterial vaginosis: a pilot study. American Journal of Obstetrics and Gynecology 198(6):628-e1.
Crossref

 

Brotman RM, Ravel J, Cone RA, Zenilman JM (2010). Rapid fluctuation of the vaginal microbiota measured by Gram stain analysis. Sexually Transmitted Infections 86(4):297-302.
Crossref

 

Bukusi EA, Cohen CR, Meier AS, Waiyaki PG, Nguti R, Njeri JN, Holmes KK (2006). Bacterial vaginosis: risk factors among Kenyan women and their male partners. Sexually Transmitted Disease 33:361-7.
Crossref

 

Burton JP, Cadieux PA, Reid G (2003). Improved Understanding of the Bacterial Vaginal Microbiota of Women before and after Probiotic Instillation. Applied and Environmental Microbiology 69(1):97-101.
Crossref

 

Burton JP, Chilcott CN, Al-Qumber M, Brooks HJ, Wilson D, Tagg JR, Devenish C (2005). A preliminary survey of Atopobium vaginae in women attending the Dunedin gynaecology out?patients clinic: Is the contribution of the hard?to?culture microbiota overlooked in gynaecological disorders? Australian and New Zealand Journal of Obstetrics and Gynaecology 45(5):450-452.
Crossref

 

Cherpes TL, Meyn LA, Krohn MA, Hillier SL (2003). Risk factors for infection with herpes simplex virus type 2: role of smoking, douching, uncircumcised males, and vaginal flora. Sexually Transmitted Disease 30:405-410.
Crossref

 

Cohen CR, Duerr A, Pruithithada N, Rugpao S, Hillier S, Garcia P, Nelson K (1995). Bacterial vaginosis and HIV seroprevalence among female commercial sex workers in Chiang Mai, Thailand. Aids 9(9):1093-1098.
Crossref

 

De Backer E, Verhelst R, Verstraelen H, Alqumber MA, Burton JP, Tagg JR, Temmerman M, Vaneechoutte M (2007). Quantitative determination by real-time PCR of four vaginal Lactobacillus species, Gardnerella vaginalis and Atopobium vaginae indicates an inverse relationship between L. gasseri and L. iners. BMC Microbiology 7:1-13.
Crossref

 

De Seta F, Campisciano G, Zanotta N, Ricci G, Comar M (2019). The Vaginal Community State Types Microbiome-Immune Network as Key Factor for Bacterial Vaginosis and Aerobic Vaginitis. Frontiers in Microbiology 2019:2451.
Crossref

 

Doerflinger SY, Throop AL, Herbst-Kralovetz MM (2014). Bacteria in the vaginal microbiome alter the innate immune response and barrier properties of the human vaginal epithelia in a species-specific manner. Journal of Infectious Diseases 209(12):1989-1999.
Crossref

 

Eschenbach DA, Davick PR, Williams BL, Klebanoff SJ, Young-Smith K, Critchlow CM, Holmes KK (1989). Prevalence of hydrogen peroxide-producing Lactobacillus species in normal women and women with bacterial vaginosis. Journal of Clinical Microbiology 27(2):251-256.
Crossref

 

Eschenbach DA, Thwin SS, Patton DL, Hooton TM, Stapleton AE, Agnew K, Winter C, Meier A, Stamm WE (2000). Influence of the normal menstrual cycle on vaginal tissue, discharge, and microflora. Clinical Infectious Diseases 30(6):901-907.
Crossref

 

Farage MA, Neill S, MacLean AB (2009). Physiological changes associated with the menstrual cycle: a review. Obstetrical & Gynecological Survey 64(1):58-72.
Crossref

 

Ferris MJ, Masztal A, Aldridge KE, Fortenberry JD, Fidel PLJr, Martin DH (2004). Association of Atopobium vaginae, a recently described metronidazole resistant anaerobe, with bacterial vaginosis. BMC Infectious Disease 4:5.
Crossref

 

Fethers KA, Fairley CK, Hocking JS, Gurrin LC, Bradshaw CS (2008). Sexual Risk Factors and Bacterial Vaginosis: A Systematic Review and Meta-Analysis. Clinical Infectious Diseases 47(11):1426-1435.
Crossref

 

Fettweis JM, Serrano MG, Brooks JP, Edwards JD, Girerd PH, Parikh HI, Huang B, Arodz TJ, Edupuganti L, Glascock AL, Xu J, Jimenez NR, Vivadelli SC, Fong SS, Sheth NU, Jean S, Lee V, Bokhari YA, Lara AM, Mistry SD, Duckworth 3rd RA, Bradley SP, Koparde VN, Orenda XV, Milton SH, Rozycki SK, Matveyev AV, Wright ML, Huzurbazar SV, Jackson EM, Smirnova E, Korlach J, Tsai Y, Dickinson MR, Brooks JL, Drake JI, Chaffin DO, Sexton AL, Gravett MG, Rubens CE, Wijesooriya NR, Hendricks-Muñoz KD, Jefferson KK, Strauss III JF, Buck GA (2019). The vaginal microbiome and preterm birth. Nature Medicine 25(6):1012-1021.
Crossref

 

Frank DN, Olivier Manigart, Valériane Leroy, Nicolas Meda, Diane Valéa, Weiming Zhang, François Dabis, Norman R Pace, Philippe Van de Perre, Edward N Janoff (2012). Altered vaginal microbiota are associated with perinatal mother-to-child transmission of HIV in African women from Burkina Faso. Journal of Acquired Immune Deficiency Syndrome 60(3):299-306.
Crossref

 

Fredricks DN, Fiedler TL, Marrazzo JM (2005). Molecular identification of bacteria associated with bacterial vaginosis. New England Journal of Medicine 353(18):1899-911.
Crossref

 

Fujisawa T, Benno Y, Mitsuoka T (1992). Effect of Menstrual Cycle and Different Age on Vaginal Microflora of Healthy Women. Bifidobacteria and Microflora 11(1):33-38.
Crossref

 

Gelber SE, Aguilar LJ, Lewis KLT, Ratner JA (2008). Functional and Phylogenetic Characterization of Vaginolysin, the Human-Specific Cytolysin from Gardnerella vaginalis. Journal of Bacteriology 190(11):3896-3903.
Crossref

 

Greenblatt RM, Bacchetti P, Barkan S, Augenbraun M, Silver S, Delapenha R, Garcia P, Mathur U, Miotti P, Burns D, Wihs Collaborative Study Group (1999). Lower genital tract infections among HIV-infected and high-risk uninfected women: findings of the Women's Interagency HIV Study (WIHS). Sexually Transmitted Disease 26:143-51.
Crossref

 

Hawes SE, Hillier SL, Benedetti J, Stevens CE, Koutsky LA, Wolner-Hanssen P, Holmes KK (1996). Hydrogen peroxide-producing lactobacilli and acquisition of vaginal infections. Journal of Infectious Diseases 174(5):1058-1063.
Crossref

 

Hay PE, Morgan DJ, Ison CA, Bhide SA, Romney M, McKenzie P, Pearson J, Lamont RF, Taylor-Robinson D (1994). A longitudinal study of bacterial vaginosis during pregnancy. British Journal of Obstetric Gynaecology 101(12):1048-1053.
Crossref

 

Hay PE, Ugwumadu A, Chowns J (1997). Sex, thrush and bacterial vaginosis. International Journal of STD & AIDS 8(10):603-608.
Crossref

 

Hay P (2005). Life in the littoral zone: lactobacilli losing the plot. Sexually Transmitted Infections 81(2):100-102.
Crossref

 

Hillier SL, Lau RJ (1997). Vaginal microflora in postmenopausal women who have not received estrogen replacement therapy. Clinical Infectious Diseases 25(Supplement_2):S123-S126.
Crossref

 

Hillier SL, Krohn MA, Rabe LK, Klebanoff SJ, Eschenbach DA (1993). The normal vaginal flora, H2O2-producing lactobacilli, and bacterial vaginosis in pregnant women. Clinical Infectious Diseases 16(Supplement_4):S273-S281.
Crossref

 

Hillier SL, Nugent RP, Eschenbach DA, Krohn MA, Gibbs RS, Martin DH, Klebanoff MA (1995). Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. New England Journal of Medicine 333(26):1737-1742.
Crossref

 

Hobbs RJ, Huenneke LF (1992). Disturbance, diversity, and invasion: Implications for conservation. Conservation Biology 6(3):324-337.
Crossref

 

Hutchinson KB, Kip KE, Ness RB (2007). Condom use and its association with bacterial vaginosis and bacterial vaginosis-associated vaginal microflora. Epidemiology 18(6):702-8.
Crossref

 

Jespers V, Kyongo J, Joseph S, Hardy L, Cools P, Crucitti T, Mwaura M, Ndayisaba G, Delany-Moretlwe S, Buyze J, Vanham G (2017). A longitudinal analysis of the vaginal microbiota and vaginal immune mediators in women from sub-Saharan Africa. Scientific Reports 7(1):11974.
Crossref

 

Kaul R, Nagelkerke NJ, Kimani J, Ngugi E, Bwayo JJ, Macdonald KS, Rebbaprgada A, Fonck K, Temmerman M, Ronald A, Moses S (2007). Prevalent Herpes simplex virus type 2 infection is associated with altered vaginal flora and an increased susceptibility to multiple sexually transmitted infections. Journal of Infectious Diseases 196(11):1692-1697.
Crossref

 

Keane FE, Ison CA, Taylor-Robinson D (1997). A longitudinal study of the vaginal flora over a menstrual cycle. International Journal of STD & AIDS 8(8):489-494.
Crossref

 

Kiama TN, Rita Verhelst, Paul M Mbugua, Mario Vaneechoutte, Hans Verstraelen, Benson Estambale, Marleen Temmerman (2014). Characterisation of the vaginal microflora of human immunodeficiency virus (HIV) positive and negative women in a sub-urban population of Kenya. African Journal of Biotechnology 13(9):1075-1085.
Crossref

 

Leitich H, Bodner-Adler B, Brunbauer M, Kaider A, Egarter C, Husslein P (2003). Bacterial vaginosis as a risk factor for preterm delivery: a meta-analysis. American Journal of Obstetrics and Gynecology 189(1):139-147.
Crossref

 

Leppäluoto PA (2011). Bacterial vaginosis: what is physiological in vaginal bacteriology? An update and opinion. Acta Obstetricia et Gynecologica Scandinavica 90(12):1302-1306.
Crossref

 

Martin HL, Richardson BA, Nyange PM, Lavreys L, Hillier SL, Chohan B, Mandaliya K, Ndinya-Achola JO, Bwayo J, Kreiss J (1999). Vaginal lactobacilli, microbial flora, and risk of human immunodeficiency virus type 1 and sexually transmitted disease acquisition. J Journal of Infectious Diseases 180(6):1863-1868.
Crossref

 

Morison L, Ekpo G, West B, Demba E, Mayaud P, Coleman R, Bailey R, Walraven G (2005). Bacterial vaginosis in relation to menstrual cycle, menstrual protection method, and sexual intercourse in rural Gambian women. Sexually Transmitted Infections 81(3):242-247.
Crossref

 

Ness RB, Hillier SL, Richter HE, Soper DE, Stamm C, McGregor J, Bass DC, Sweet RL, Rice P (2002). Douching in relation to bacterial vaginosis, lactobacilli, and facultative bacteria in the vagina. Obstetrics & Gynecology 100(4):765-772.
Crossref

 

Ness RB, Hillier SL, Kip KE, Soper DE, Stamm CA, McGregor JA, Bass DC, Sweet RL, Rice P, Richter HE (2004). Bacterial vaginosis and risk of pelvic inflammatory disease. Obstetrics & Gynecology 104(4):761-769.
Crossref

 

Ness RB, Kip KE, Soper DE, Stamm CA, Rice P, Richter HE (2006). Variability of bacterial vaginosis over 6- to 12-month intervals. Sexually Transmitted Diseases 33(6):381-385.
Crossref

 

Nugent RP, Krohn MA, Hillier SL (1991). Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. Journal of Clinical Microbiology 29(2):297-301.
Crossref

 

Nyirjesy P (2008). Vulvovaginal candidiasis and bacterial vaginosis. Infectious Disease Clinics of North America 22(4):637-652.
Crossref

 

Onderdonk AB, Zamarchi GR, Walsh JA, Mellor RD, Munoz A, Kass EH (1986). Methods for quantitative and qualitative evaluation of vaginal microflora during menstruation. Applied and Environmental Microbiology 51(2):333-339.
Crossref

 

Owen JA Jr. (1975). Physiology of the menstrual cycle. American Journal of Clinical Nutrition 28(4):333-338.
Crossref

 

Priestley CJ, Jones BM, Dhar J, Goodwin L (1997). What is normal vaginal flora? Genitourinary Medicine 73(3):23-8.
Crossref

 

Ravel J, Gajer P, Abdo Z, Schneider MG, Koenig SSK, McCulle SL, Karlebach S, Gorle R, Russell J, Tacket CO, Brotman RM, Davis CC, Ault K, Peralta L, Forney LJ (2010). Vaginal microbiome of reproductive-age women. Proceedings of the National Academy of Sciences 108(supplement_1):4680-4687.
Crossref

 

Riggs MM, Sethi AK, Zabarsky TF, Eckstein EC, Jump RLP, Donskey CJ (2007). Asymptomatic Carriers Are a Potential Source for Transmission of Epidemic and Nonepidemic Clostridium dif?cile Strains among Long-Term Care Facility Residents. Clinical Infectious Diseases 45(8):992-998.

Rodriguez Jovita M, Collins MD, Sjoden B, Falsen E (1999). Characterization of a novel Atopobium isolate from the human vagina: description of Atopobium vaginae sp. nov. International Journal of Systematic and Evolutionary Microbiology 49(4):1573-1576.
Crossref

Royce RA, Thorp J, Granados JL, Savitz DA (1999). Bacterial vaginosis associated with HIV infection in pregnant women from North Carolina. Journal of Acquired Immune Deficiency Syndromes 20(4):382-386.
Crossref

 

Santiago GLS, Deschaght P, Aila NE, Kiama TN, Verstraelen H, Jefferson KK, Temmerman M, Vaneechoutte M (2011). Gardnerella vaginalis comprises three distinct genotypes of which only two produce sialidase. American Journal of Obstetrics and Gynecology 204(5):450-e1-7.
Crossref

 

Sautter RL, Brown WJ (1980). Sequential vaginal cultures from normal young women. Journal of Clinical Microbiology 11(5):479-484.
Crossref

 

Schwebke JR, Morgan SC, Weiss HL (1997). The use of sequential self-obtained vaginal smears for detecting changes in the vaginal flora. Sexually Transmitted Diseases 24:236-239.
Crossref

 

Schwebke JR, Richey CM, Weiss HL (1999). Correlation of Behaviour with microbiological changes in vaginal flora. Journal of Infectious Diseases 180(5):1632-1636.
Crossref

 

Schwebke JR, Desmond RA, Oh MK (2004). Predictors of bacterial vaginosis in adolescent women who douche. Sexually Transmitted Diseases 31:433-436.
Crossref

 

Sewankambo N, Gray RH, Wawer MJ, Paxton L, McNaim D, Wabwire-Mangen F, Serwadda D, Li C, Kiwanuka N, Hillier SL, Rabe L, Gaydos CA, Quinn TC, Konde-Lule J (1997). HIV-1 infection associated with abnormal vaginal flora morphology and bacterial vaginosis. The Lancet 350(9077):546-550.
Crossref

 

Song SD, Acharya KD, Zhu JE, Deveney CM, Walther-Antonio MRS, Tetel MJ, Chia N (2020). Daily Vaginal Microbiota Fluctuations Associated with Natural Hormonal Cycle, Contraceptives, Diet, and Exercise. American Society for Microbiology 5(4):e00593-20.
Crossref

 

Spear GT, Sikaroodi M, Zariffard MR, Landay AL, French AL, Gillevet PM (2008). Comparison of the diversity of the vaginal microbiota in HIV-infected and HIV-uninfected women with or without bacterial vaginosis. Journal of Infectious Diseases 198(8):1131-1140.
Crossref

 

Spear GT, Gilbert D, Landay AL, Zariffard R, French AL, Patel P, Gillevet PM (2011). Pyrosequencing of the Genital Microbiotas of HIV-Seropositive and -Seronegative Women Reveals Lactobacillus iners as the Predominant Lactobacillus Species. Applied and Environmental Microbiology 77(1):378-381.
Crossref

 

Srinivasan S, Liu C, Mitchell CM, Fiedler TL, Thomas KK, Agnew KJ, Marrazzo JM, Fredricks DN (2010). Temporal variability of human vaginal bacteria and relationship with bacterial vaginosis. PLoS ONE 5(4):e10197.
Crossref

 

Starc M, Lu?ovnik M, Vrli? PE, Jeverica S (2022). Protective Effect of Lactobacillus crispatus against Vaginal Colonization with Group B Streptococci in the Third Trimester of Pregnancy. Pathogens 11(9):980.
Crossref

 

Swidsinski A, Mendling W, Loening-Baucke V, Ladhoff A, Swidsinski S, Hale LP, Lochs H (2005). Adherent biofilms in bacterial vaginosis. Obstetrics & Gynecology 106(5 Part 1):1013-1023.
Crossref

 

Taha TE, Hoover DR, Dallabetta GA, Kumwenda NI, Mtimavalye LA, Yang LP, Liomba GN, Broadhead RL, Chiphangwi JD, Miotti PG (1998). Bacterial vaginosis and disturbances of vaginal flora: association with increased acquisition of HIV. Aids 12(13):1699-1706.
Crossref

 

Tweten RK (2005). Cholesterol-dependent cytolysins, a family of versatile pore-forming toxins. Infection and Immunity 73(10):6199-6209.
Crossref

 

Vallor AC, Antonio MA, Hawes SE, Hillier SL (2001). Factors associated with acquisition of, or persistent colonization by, vaginal lactobacilli: role of hydrogen peroxide production. Journal of Infectious Diseases 184(11):1431-1436.
Crossref

 

Vasquez A, Jakobsson T, Ahrne S, Forsum U, Molin G (2002). Vaginal Lactobacillus flora of healthy Swedish women. Journal of Clinical Microbiology 40(8):2746-2749.
Crossref

 

Verhelst R, Verstraelen H, Claeys G, Verschraegen G, Delanghe J, Van Simaey L, De Ganck C, Temmerman M, Vaneechoutte M (2004). Cloning of 16S rRNA genes amplified from normal and disturbed vaginal microflora suggests a strong association between Atopobium vaginae, Gardnerella vaginalis and bacterial vaginosis. BMC Microbiology 4:1-11.
Crossref

 

Verhelst R, Verstraelen H, Claeys G, Verschraegen G, Van Simaey L, De Ganck C, De Backer E, Temmerman M, Vaneechoutte M (2005). Comparison between Gram stain and culture for the characterization of vaginal microflora: definition of a distinct grade that resembles grade I microflora and revised categorization of grade I microflora. BMC Microbiology 5:1-11.
Crossref

 

Verstraelen H, Verhelst R, Claeys G, De Backer E, Temmerman M, Vaneechoutte M (2009). Longitudinal analysis of the vaginal microflora in pregnancy suggests that L. crispatus promotes the stability of the normal vaginal microflora and that L. gasseri and/or L. iners are more conducive to the occurrence of abnormal vaginal microflora. BMC Microbiology 9(1):1-10.
Crossref

 

Walker BH (1992). Biodiversity and Ecological redudancy. Conservation Biology 6(1):18-23.
Crossref

 

Wang Y, Noël-Romas L, Perner L, Knodel S, Molatlhegi R, Hoger S, Birse K, Zuend CF, McKinnon LR, Burgener AD (2023). Non-Lactobacillus-dominant and polymicrobial vaginal microbiomes are more common in younger South African women and predictive of increased risk of human immunodeficiency virus acquisition. Clinical Infectious Diseases 76(8):1372-1381.
Crossref

 

Watts DH, Springer G, Minkoff H, Hillier SL, Jacobson L, Moxley M, Justman J, Cejtin H, O'Connell C, Greenblatt RM (2006). The occurrence of vaginal infections among HIV-infected and high-risk HIV-uninfected women: longitudinal findings of the women's interagency HIV study. Journal of Acquired Immune Deficiency Syndromes 43(2):161-168.
Crossref

 

Wilks M, Tabaqchali S (1987). Quantitative bacteriology of the vaginal flora during the menstrual cycle. Journal of Medical Microbiology 24(3):241-245.
Crossref

 

Wilks M, Wiggins R, Whiley A, Hennessy E, Warwick S, Porter H, Corfield A, Millar M (2004). Identification and H2O2 production of vaginal lactobacilli from pregnant women at high risk of preterm birth and relation with outcome. Journal of Clinical Microbiology 42(2):713-717.
Crossref

 

Wilson JD, Lee RA, Balen AH, Rutherford AJ (2007). Bacterial vaginal flora in relation to changing oestrogen levels. International Journal of STD & AIDS 18(5):308-311.
Crossref

 

Yotebieng M, Turner AN, Hoke TH, Van Damme K, Rasolofomanana JR, Behets F (2009). Effect of consistent condom use on 6?month prevalence of bacterial vaginosis varies by baseline BV status. Tropical Medicine & International Health 14(4):480-486.
Crossref

 

Zhou X, Brown JC, Abdo Z, Davis CC, Hansmann MA, Joyce P, Foster JA, Forney LJ (2007). Differences in the composition of vaginal microbial communities found in healthy Caucasian and black women. International Society for Microbial Ecology 1(2):121-133.
Crossref

 

Zhou X, Hansmann MA, Davis CC, Suzuki H, Brown CJ, Schütte U, Pierson JD, Forney LJ (2009). The vaginal bacterial communities of Japanese women resemble those of women in other racial groups. FEMS Immunology & Medical Microbiology 58(2):169-181.
Crossref